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Dungeons and dragons: The use of a fantasy game in the psychotherapeutic treatment of a young adult

Blackmon, Wayne DAmerican Journal of Psychotherapy; Washington Vol. 48, Iss. 4,  (Fall 1994): 624-32. DOI:10.1176/appi.psychotherapy.1994.48.4.624

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This article demonstrates how a young man with an obsessional, schizoid personality was treated by utilizing a fantasy game, Dungeons and Dragons, as a vehicle for releasing his unconscious fantasies. It aims to show how the game may serve to free fears and feelings for useful consciousness with enhanced ego development so as to improve the patient's ability to interact with others and feel comfortable with himself.


Fred, a 19-year-old, single white college student, had cut both of his wrists in a methodical suicide attempt and had gone into the shower in an effort to prevent the wounds from coagulating. He claimed that he had been depressed for several years, actually since grade school and that he had always been a "loner." Friendships he did develop were usually short-term and superficial. College, he reported, had been particularly lonely for him and he had done little outside of school work. Yet he could not describe any unusual events or possible precipitants. However he reported that school work, which had been an area of success for him, had lately been going badly.

Fred gave no indication of sleep or appetite disturbance, spontaneous crying spells, depressive dreams, constipation, weight loss or other signs of endogenous depression. He denied any hallucinations or delusions.


Fred grew up in a small town. His father is in the legal profession, "likes his work," and is very formal and not close at all. The mother is a housewife but is "otherwise a pretty good mother." He is the second of three brothers. The oldest brother is three years older than Fred and has an undefined physical condition, "a problem with the vessels on one side of his brain" (probably Sturge-Weber syndrome) and is retarded. He stays home, "mooching" off the parents. Fred never got along...